Orcas Family Health Center Joins NWRPCA! • On March 16, 2010 the Northwest Regional Primary Care Association (NWRPCA) welcomed Orcas Family Health Center (OFHC) as its newest member organization. NWRPCA is a non-profit 501(c)3 membership association that works to ensure equal access, regardless of one's financial or insurance status, to primary and preventative health care for all residents living in Washington, Oregon, Idaho and Alaska. To do this NWRPCA leverages its regional power to support and advocate for community-based health centers at the national level, and to provide training and workforce development support, helping them to become model "professional homes" to their staff and board members.

According to David Shinstrom, MD, the medical director of OFHC," our practice on Orcas is roughly 40% Medicare, 30% commercial insurance and 30% uninsured." The Health Center, staffed by Dr. Shinstrom, Nurse Practitioner Phoebe Hershenow, and a support staff of seven offers full-service primary care, including immunizations, screenings, pediatric and adult medicine, laboratory services, surgery, OB/GYN support, mental health care, and emergency services.Consistent with federal guidelines, OFHC offers all of the foregoing services on a sliding fee scale, making it possible for every member of the community to receive primary care.

OFHC has an active patient base of 2,500, with more than 5,500 patient encounters during the past year. The Health Center provides resources and access to primary care through direct support and grant funding. Among the organizations served are: DVSAS Orcas Island, United Way of San Juan County, North Cascade Cardiology, Orcas Island Physical Therapy, Island Hospital Home health, Island Convalescent Center, Medical Diagnostic Laboratories, OPALCO (local power co-op), Orcas Fire Department and EMS, David Russel MD, Stephen Bailey DDS, Compass Health, YMCA Camp Orkila, Susan G. Komen for the Cure, The Funhouse, Orcas Island Prevention Partnership, Orcas Family Connections, Orcas Senior Center, Kaleidoscope-Orcas Day Care, the Orcas Island Community Foundation and Camp four Winds-Westward Ho!

Dr Shinstrom sees the relationship with NWRPCA as natural, "We chose to join our regional primary care association because their mission is about healthcare justice for all. We have taken advantage of their educational conferences in the past and our operations manager has earned medical coding certification through NWRPCA as well as valuable medical accounting, human resource and management training. It just make sense to join a regional member association that shares our values and our mission."

NWRPCA Chief Executive Officer Bruce Gray noted that the new relationship with OFHC will contribute to regional efforts to "grow our own" primary care clinicians. "With Dave Shinstrom on the University of Washington faculty and already familiar with their residency programs, we now have another member Health Center eager to attract medical students for rotations. Our hope and plan is that students who train in the community Health Centers of the Northwest will eventually choose to practice here." •

DR. SHINSTROM NOMINATED FOR JEFFERSON AWARD • Dr. David Shinstrom, Director of Orcas Family Health Center, has been nominated for the 2010 Washington State Jefferson Awards for Public Service.

Initiated in 1972 to create a "Nobel Prize" for public service, Seattle's City Club Jefferson Awards honor ordinary citizens who do extraordinary things for others. Five volunteers from Washington State will receive the State Jefferson award for their outstanding volunteerism. The winners will be judged by a panel of community leaders and their stories will be told on King 5 TV's Evening Magazine the Week of April 5th through the 9th.

One winner will represent Washington State in Washington D.C. at a later time. •

X-ray Center Opens at OFHC • Orcas Family Health Center has just put into service a new
X-ray machine that has the capability to transmit X-rays digitally to off-island specialists as fast as sending an
e-mail. That means that within 30 minutes or less OFHC can get back a second opinion verification of diagnosis from radiologists affiliated with St. Joseph's Hospital in Bellingham. In fact, these X-rays could be sent anywhere in the world to be read and verified by physicians specially trained in the reading of X-rays. Having knowledge of this, as a patient, should instill an additional degree of confidence, peace of mind and a sense of security that is unparalleled.

The decision to go forward with this expensive installation is very much in keeping with our pledge, as a 501(c)3 charitable, nonprofit, rural health center, to provide the very best medical care to everyone regardless of their ability to pay. Our Medical Director, Dr. David Shinstrom is making our new equipment available to all qualified practitioners, including visiting Specialists like Northwest Cardiology. Having checked with the Washington State Health Department, no reasons could be found to not extend this user courtesy to our local Veterinarians as well. Many animal lovers are excited by the prospect of not only avoiding an off-island trip; but, more importantly of being able to get a diagnosis and treatment for their injured pet in a very short period of time.

As a final and, hopefully, gentle reminder, OFHC has taken on significant debt to provide this capability. Your tax deductible financial gift, regardless of the amount, will help us to continue helping our island community. •

OFHC PURCHASES COLPOSCOPE • In an effort to expand services to patients, OFHC has purchased a colposcope. This machine has enhanced, lighted magnification to evaluate women with abnormal pap sears. the colposcope allows for a better view of the tissues that may be the cause of the abnormality.

"In the past we have had to refer our patients off-island for this procedure; it will be a tremendous benefit to be able to save them the trip," notes OFHC medical director Dr. David Shinstrom. "I learned colposcopy several years ago and actually trained family medicine residents how to perform the procedure. There is a colposcope at the Orcas Island Medical Center that was purchased by the Orcas Island Medical Guild but other medical practices are not allowed to use it. Ours may be used by any medical practitioner on Orcas who is trained in it's use."

This instrument can also double as a dermatoscope to view abnormal skin lesions. "The optics and magnification with this scope are excellent and will allow close up views of abnormal skin lesions.," comments Shinstrom. "This is a classic case of a two for one benefit."

The colposcope was purchased using donated funds. •

Dr. Shinstrom Reappointed to UW Faculty • For the fourteenth consecutive year, the University of Washington School of Medicine, Department of Family Medicine has reviewed his credentials and reappointed Orcas Family Health Center (OFHC) physician David Shinstrom as Clinical Instructor. The reappointment commented "we simply could not meet our missions in education, research and clinical service without your generosity and commitment." Shortly after arriving on Orcas in 1993, Shinstrom contacted the University to become a part of the training for medical students and family medicine residents. Since then dozens of aspiring physicians have spent a 3-4 week rotation experiencing the unique rural medical practice characteristic of Orcas.

"It really is an eye opening time for them," notes Shinstrom. "They are accustomed to having easy access to emergency services and sophisticated testing equipment available in the big city and must readjust to a new reality. Practicing medicine on Orcas, with so little in the way of testing, makes them rely on the patient encounter as the primary source of information."The reviews of the experience here are extremely positive. One student noted, "Dr. Shinstrom is an excellent teacher. He made every patient I saw an interesting teaching case." Another noted"my experience on Orcas island was excellent overall."

:I very much appreciate the willingness of our patients to be seen and evaluated by these students and residents," commented Shinstrom. "Having established these relationships with so many physicians in training has a side benefit of helping recruit for a physician to join our practice." This upcoming summer four of the trainees who have now graduated will be coming to Orcas for varying periods of time to assist in patient care."Our summertime volume often is 30% greater than other times of the year, so I appreciate being able to handle the increase with these highly qualified physicians. It is hoped one of them may decide to remain."

OFHC is a 501(c)(3) Federal Rural Health Center with a mission of treating all patients regardless of ability to pay. Board president Ken Speck comments, "the board is extremely proud of David and what he has done with our medical practice. all of Orcas benefits from this relationship we have with the University of Washington." •